Covid-19: Second wave if mistake repeated

The country may have to grapple with a second wave of coronavirus infections if the government fails to ensure strict institutional quarantine for 29,000 Bangladeshi workers set to return from the Middle East over the next couple of weeks.

A government-appointed expert committee has warned the Directorate General of Health Services (DGHS) in this regard.

Many of these Bangladeshis are now in prisons or detention camps in the Middle Eastern countries. They have, however, been granted general amnesty due to the coronavirus pandemic, foreign ministry sources said.

"If the government allows them to go into home quarantine instead of keeping them in institutional quarantine, there will be a bigger disaster for us in the coming days," a member of the committee told The Daily Star yesterday, on the condition of anonymity.

Speaking to The Daily Star on Thursday, Dr Liaquat Ali, a medical scientist and member of the government committee, said, "Earlier, we submitted a report to the DGHS saying that the Covid-19 outbreak may reach its peak in the third or fourth week of this month and the situation would remain unchanged for almost two weeks, or until the first week of June.

"But now we have warned the government that there will be a second peak if the respective authorities fail to ensure institutional quarantine [for the workers coming back to the country]."

In late March, the health ministry formed the eight-member expert committee to supervise, monitor and support the coronavirus response.

It includes public health experts Dr MA Foyez, Prof Dr Shah Monir Hossain, Dr Liaquat Ali, Dr Iqbal Anwar and Prof Fazlur Rahman, among others.

SAME MISTAKE?

On May 6, Foreign Minister AK Abdul Momen said Dhaka is expecting to receive nearly 29,000 Bangladeshi workers from Middle Eastern countries, especially from the United Arab Emirates, Saudi Arabia, Oman, Kuwait, Qatar, Jordan, Lebanon and Iraq, in the next couple of weeks.

Of the 29,000, Kuwait will send 4,500, Saudi Arabia 4,262 and Oman will send nearly 1,000 Bangladeshi citizens, according to the foreign minister.

Speaking to The Daily Star recently, Momen said Bangladesh had requested different countries not to send back the Bangladeshi workers in the middle of the Covid-19 outbreak. But they didn't pay heed to the request.

Dr Shamima, an official at the heath desk in Hazrat Shahjalal International Airport (HSIA), told The Daily Star on Thursday that Kuwait has already started repatriating Bangladeshi workers.

She said 311 workers, who were in different prisons or deportation camps of Kuwait, returned to Dhaka on April 12 and all of them were sent into home quarantine as they showed health certificates saying they did not have Covid-19.

Health experts, however, raised questions about the certificates.

Prof Muzaherul Huq, former adviser (Southeast Asia Region) of the World Health Organization, said passengers with certificates stating negative test results may also be infected if the virus is in its incubation period.

"Therefore, we should not repeat the same mistake we made at the beginning by allowing Bangladeshi expatriates to be home-quarantined, as it was disastrous for us. We must learn from the mistake," he observed.

Officials at the health desk at HSIA said that at present, there are only three places with the bed capacity to keep around 700 people coming from abroad in institutional quarantine.

They are Ashkona Hajj Camp, Diabari, and Brac Learning Centre in Uttara.

WHY A SECOND PEAK

Explaining the possibility of another peak, a member of the government committee said, "We have had a bitter experience in the recent past by allowing migrant Bangladeshis to go into home quarantine. Almost nobody cared to stay home, let alone follow proper health guidelines."

Besides, in socio-economic conditions like ours, most people don't have facilities at their homes to ensure that the guidelines are being followed, he added.

"To tell the truth, home quarantine is not practical and feasible for many of our people."

Another member of the committee said, "Earlier, we predicted the number of new cases was likely to come down to a tolerable level by the end of June, unless the restrictions are relaxed too early."

"But now we think the return of the huge number of Bangladeshi prisoners from the Middle East will wreak havoc unless they are kept in mandatory institutional quarantine."

Wishing anonymity, he also said, "Many of us cannot follow quarantine guidelines at home. This is because most people simply don't have accommodations that provide separate rooms and bathrooms for those quarantined."

Moreover, he said, there is hardly any surveillance infrastructure in place to track whether the said person is indeed maintaining self-quarantine, which renders the whole process doubtful.

He also said that in different countries, including Vietnam, no passenger was allowed to stay in home quarantine.

The committee added that it will be quite some time before there is zero transmission.

Prof Muzaherul Huq said once those expats return, they must be sent to institutional quarantine for 14 days.

"Home quarantine is not practical, feasible and reliable in our country. Here a person [suspect] can roam around while at home quarantine," he added.

WAY OUT

Muzaherul said the authorities should do rapid dot blots and separate the migrant workers, who would test positive, to avoid further transmission. Then they would have to go through the PCR test too.

The rest, who would test negative in the rapid test diagnosis, would have to remain in institutional quarantine for two weeks, he added.

Dr Liaquat Ali, also an educationist, said the government should immediately engage respective communities to transform educational institutions into institutional quarantine facilities.

He also said the government should create public awareness in this regard, adding, "If we do not begin the process right now, the situation will turn grave."

According to a May 13 report by National Disaster Response Coordination Center, 615 establishments across the country with a capacity of 30,955 people were ready for institutional quarantine.

A total of 2,27,642 people were sent into quarantine till May 13, of which 2,14,701 were in home quarantine and 12,9,41 in institutional quarantine, says the report.

On the same date, 45,281 people were already quarantined -- 41,349 at home and 3,932 at institutional facilities.

Meanwhile, total of 1,82,361 were released from all kinds of quarantine till that date.